Pituitary stalk interruption syndrome(PSIS) is a rare disease characterized by different degrees of anterior pituitary hormone deficiency.The typical imaging finding is a thin or absent pituitary stalk,often associated with an ectopic posterior pituitary and a hypoplastic anterior pituitary.The cause is still unkown.Dynamic contrastenhanced MRI helps to confirm the diagnosis.Replacement of multiple anterior pituitary hormones is the key of the treatment.Doctors should have a thorough understanding of the disease and give patients efficacious treatment and a better prognosis would be obtained.

ObjectiveTo study the special effect of oxytocin and vasopressin mRNA expression by acupuncturing acupoint ST36.Methods78 SD male rats were divided into four groups, acupuncturing ST36 group, acupuncturing para-acupoint ST36 group, bondage group and control group. RT-PCR was used to observe the oxytocin and vasopressin mRNA expression in 2,4,6,8 hours after acupuncture, semi-quantitative result was obtained by using image analysis system.ResultsOxytocin mRNA expression in hypothalamus in 2,4 hours was the statistically significant different in acupuncturing para-acupoint ST36 group contrast with other three groups, while there was not statistically different between all groups on oxytocin mRNA expression in 6,8 hours. Vasopressin mRNA expression in hypothalamus in 2,4,6,8 hours was statistically depressed in acupuncturing acupoint ST36 contrast with other three groups.ConclusionOxytocin mRNA expression in hypothalamus increases for short time after acupuncturing para-acupoint ST36. Vasopressin mRNA expression in hypothalamus decreases for long time after acupuncturing acupoint ST36.

ObjectiveTo investigate effects of electroacupuncture(EA) of Zusanli(ST36) on changes of substance P(SP) mRNA expression in rat brain stem.Methods78 SD rats were evenly randomized into Zuanli-EA group, non-acupoint group, bondage groups(at the end of 2h,4h,6h,8h after 30 minute EA stimulation in each group) and control group. RT-PCR and image processing were used to study the change of SP mRNA level in brain stem.ResultsIn control groups,there was SP expression. An increase of SP mRNA expression was seen in Zusanli group and non-acupoint group comparing with control group at the end of 2h after 30min EA stimulation(P<0.05).There was difference between above two groups at the end of 6h and 8h(P<0.05).ConclusionEA stimulation elicited an accelerated expression of SP gene. Zusanli-EA stimulation can increased this expression, which may constitute one of the mechanisms for gastrointestinal motility and eletroacupuncture analgesia.

Objective To investigate the clinical characteristics of multiple endocrine neoplasia type 1(MEN1)patients presenting with hypoglycemic coma as chief manifestation and the related clinical experience in diagnosis and therapy.Methods We analyzed the clinical data of 4 patients who were hospitMized because of recurrent hypoglycemic coma and diagnosed as having MEN1 by endocrinolgical,radiological and pathological examinations.Results In the 4 cases of Whipple trilogy,radiological examination showed occupying lesion in the pancreas and pathological examination confirmed the diagnosis of insulinoma.In 2 cases the insulinomas were multiple.In this series,one cage was complicated with pituitary adenoma,parathyroidoma(recurrent after operation)and adrenocortical adenoma,one case with pituitary adenoma,parathyroidoma(2 tumors)and adrenal nodular hyperplasia,one case with pituitary adenoma and parathyroidoma,and the remaining one with pituitary adenoma and suspectable parathyroidoma.Conclusions For patients with insulinoma,MEN1 should be considered.In patients with MEN1,the presence of multiple or ectopic Darathymid adenomas(or hyperplasia)and insulinomas should be inspected during operation.After operation,examinations should be regularly performed to identify whether the diseases relapse or new endocrine neoplasias occur.

Background and objectives Hyperhomocysteinemia is an independent risk factor for cardiovascular disease. Homocysteine thiolactone (HcyT), one of the homocysteine metabolites in vivo, is toxic both in vivo and in vitro. The aim of this study was to investigate the effect of HcyT on apoptotic damage in human umbilical vein endothelial cells (HUVECs) and the role of antioxidants in the reduction of HcyT-induced apoptosis. Methods HUVECs were cultured in DMEM supplemented with 20% heat inactivated fetal bovine serum cell cultures were maintained in a humidified 5% CO2 atmosphere at 37 ℃. Cytotoxicity was determined by MTT assay,which consists of hypodiploid cells with propidium iodide labeling and intracellular reactive oxygen species levels using 2',7'-dichlorofluorescein diacetate as the probe by flow cytometry. Results HcyT (250-2000μM) induced HUVECs apoptosis in a time- and concentration-dependent manner. Reactive oxygen species levels rose in response to increasing HcyT concentrations at 24-h incubation.The reduction of cell apoptosis by N-acetylcysteine, vitamin E, or pyrrolidine dithiocarbamate, occurred simultaneously with a significant decrease in intracellular reactive oxygen species levels. Conclusion HcyT exerts its cytotoxic effects on endothelial cells through an apoptotic mechanism involving cellular reactive oxygen species production. The capacity of N-acetylcysteine, vitamin E, and pyrrolidine dithiocarbamate to scavenge HcyT-induced cellular reactive oxygen species correlates well with their efficiency to protect against HcyT-promoted apoptotic damage. The protective effect of pyrrolidine dithiocarbamate on cell apoptosis indicates HcyT-generated hydrogen peroxide may provoke cell apoptosis via activating nuclear factor-kappa binding protein.

Objective To study the expression of leukemia-related protein 16 (LRP16) in human pituitary prolactin adenomas (PRL adenomas), and the relationship between LRP16 and estrogen receptorα (ERα).Methods From October 2009 to September 2014, thirty-one adult patients diagnosed and pathologically confirmed as pituitary prolactin (PRL) adenomas (observation group) and 22 pituitary non-PRL adenomas (control group) in the Chinese PLA General Hospital were verified by the pathological examination. Immunohistochemical method was used to detect the expression levels of LRP16, PRL and ERα.Results Of the patients in observation group, those aged under 30 were predominantly females, while male patients were more common in those aged over 30. LRP16 positively existed in 26 cases (83.9%, 26/31), and ERα was positive in 28 cases (90.3%, 28/31), the both ratios were significantly higher than those in control group. ERα and LRP16 increased synchronously both in expressive content and intensity, showing a certain positive correlation between them.Conclusions Higher body mass index may be a high-risk factor badly affected the occurrence, development and prognosis in male patients with pituitary PRL; LRP16 may take part in the proliferation and formation of pituitary PRL adenomas through ERα.

Objective To analyze the clinical characteristics of the patients with pituitary stalk interruption syndrome (PSIS) in our hospital in the past seven years, and to achieve better comprehension of this kind of disease. Methods Five patients with PSIS (4 males, 1 female) in our hospital were retrospectively analyzed, regarding clinical manifestation, laboratory and imaging data. Results The clinical features of 5 cases of PSIS were as follows: (1) growth retardation; (2) high incidence of breech delivery; (3) 159-165 cm in body height; (4) retarded bone age; (5) average intelligence; (6) adenohypophyseal dysfunction in clinical and laboratory examinations; (7) normal posterior pituitary function; (8) MRI with gadolinium contrast revealed no pituitary stalk and anterior pituitary hypoplasia with ectopic posterior pituitary. The pathogenesis of PSIS is not clear. Appropriate hormonal replacement therapy is the only effective way. Conclusion PSIS is rarely seen and its clinical feature is different from pituitary dwarfism and hypogonadotropic hypogonadism. The realization for this syndrome should be emphasized and early therapy is essential.

To study thyroid hormone receptor β(THRβ)gene mutation in a pituitary-resistance to thyroid hormone syndrome family. The peripheral blood samples of the patient, his sister, parents, and 4 maternal relatives were collected. Then serum was isolated for detecting thyroid hormone levels with chemiluminescence immunoassay, and DNA was extracted for PCR, and 10 exons of THRβ gene were sequenced. The patient and his mother had the hyperthyroid symptom for many years and his mother with atrial fibrillation. The G→A heterozygous transition mutation was confirmed by exon sequencing at nucleotide 949 within exon 9 of THRβ gene in the patient and his mother, which was a missense mutation causing a substitution of Alanine to Threonine(A317T). No mutation was found in THRβ gene in other family members. This is the first Chinese family reported with pituitary thyroid hormone resistance syndrome caused by a A317T mutation in the thyroid hormone receptor β gene.

Ovotestis is a rare disorder of sexual differentiation in which the gonads have both ovarian and testicular elements. The patients always present with ambiguous external genitalia, and there are usually with serious disorder between chromosomal sex, gonadal sex, social sex, and psychological sex. The definite diagnosis and gender confirmation, appropriate surgery in internal genitalia and orthomorphia in external genitalia, as well as psychological support are essential for a multidisciplinary medical group in managing this disease. The medical data of two children with ovotestis who were reared as boy or girl respectively were analyzed.

Objective To study the cerebrospinal fluid(CSF) and serum level of human chorionic gonadotropin (HCG) in patients with intracranial germinoma and to evaluate its diagnostic and therapeutic value. Methods Thirty-one patients with intracranial germinoma receiving estimation of HCG in CSF and serum in our hospital were retrospectively analyzed in terms of HCG level, its influencing factors and the relationship of HCG with clinical features. Results HCG levels in CSF of the 31 cases ranged from 0. 17 IU/L to 5316. 98 IU/L with a median value of 3.44 IU/L. The sensitivity of diagnosis increased from 80. 6% to 90. 3%, when the cut point of HCG in CSF changed from 0. 60 IU/L to 0. 50 IU/L. The sensitivity increased from 83.9% to 93.5% when the cut point of the ratio of CSF/serum HCG decreased from 1.8 to 1.7. HCG level of germinoma located in pineal region was higher than that in basal ganglia region, while it is lowest in sellar region. The ratio of CSF/serum HCG in different parts showed no difference. Multiple risk factors analysis revealed that serum HCG (r =0. 886,P =0. 0001 ) and tumor size ( r=0.748, P=0.0211 ) were positively correlated with the HCG level in CSF, while course of the disease,age and gender were not correlated. After radiation therapy, HCG in CSF and serum decreased dramatically as compared with those before radiation. Conclusions The HCG level and its dynamic change were sensitive marker of intracranial germinomas. Based on our analysis, HCG in CSF over 0. 50 IU/L and the its ratio in CSF/serum over 1.7 were highly indicative of the possibility of intracranial germinomas.